Health insurance

There are different types of health insurance policies. These include:

  • mortgage payment protection (MPPI)
  • critical illness cover
  • income protection insurance
  • payment protection insurance
  • private medical insurance

A cancer diagnosis can trigger a payout from these schemes. This may be a lump sum, a monthly income, continuing payments on your behalf or reimbursing the cost of private treatment. There is usually a time limit on claims. Try to claim as soon as possible if you are eligible. Insurers make careful checks after a claim and you may be asked to have a medical examination. If don’t already have health insurance, it could be harder to get if you have cancer. You may be asked questions about your health or the health of family members. Insurers use this information to assess the likelihood of you making a future claim.

If you are recovering from cancer, your insurance may exclude claims relating to your illness. But conditions that develop after you have taken out a policy don’t usually affect your cover.

Buying health insurance

Health insurance can pay you money if you become too ill to work. It can also help cover medical costs.

There are different types of health insurance, including

  • mortgage payment protection insurance (MPPI)
  • critical illness cover
  • income protection insurance
  • payment protection insurance
  • private medical insurance.

When you are buying health insurance, it is important to know that insurers can arrange health insurance in two different ways:

Moratorium underwriting

Some insurers use this to help you get cover in the future for a health condition you are recovering from.

Types of insurance such as MPPI, other loan protection insurance and short-term income protection usually use moratorium underwriting. Some types of private medical insurance also use it.

Moratorium underwriting means the policy does not cover claims linked to health conditions you have, or have recently had, at the time you take out the policy.

This exclusion usually lasts for the first one or two years of the policy. This is called the moratorium period.

If a claim is made after the moratorium period, the health condition is covered as long as there are no more symptoms, medical advice or treatment (including taking medication) during the moratorium period.

Full medical underwriting

This is a process an insurer uses to work out how likely you are to make a claim on an insurance policy.

Income protection insurance and critical illness cover usually use full medical underwriting. Some types of private medical insurance also use it.

The insurer may ask for your full medical history. This includes information about your health, your lifestyle and the health of your close family members. They may do this through questions and medical reports.

Based on this assessment, they will decide whether to offer you cover, what premium to charge you and any other special terms or limits to include.

Health conditions that develop after you have taken out a policy don’t usually affect your premium or cover. But they may affect the terms you are offered if you wanted to switch to a different policy.


Employer health insurance

Some employers arrange health insurance for their employees on a group basis. This means all their employees can get health insurance cover through an insurer that the employer has chosen. This may be private medical insurance, critical illness insurance or income protection insurance. Cover is often given up to a set amount of money for employees who have joined the scheme. It is not affected by any health conditions they may already have. Contact your human resources (HR) department at work to find out whether your employer offers any group health insurance schemes that you can join.


How cancer can affect buying health insurance

If you have had cancer or are living with cancer, you usually can’t get any health insurance cover for claims related to your cancer. In some cases, you may be refused health insurance because of your cancer.

Insurers can also ask questions about the health of other people in your family. This is because people with close family members (such as parents, brothers and sisters) who have had cancer may, in a small number of cases, be at a higher risk of getting the same cancer.

You can have genetic tests to check whether you are at a high risk of getting some types of cancer. There are two types of test:

  • Diagnostic tests are carried out when you already have symptoms. You will usually have to tell your insurer about any diagnostic tests that you are having.
  • Predictive tests aim to assess how likely it is that you might develop a medical condition. Insurers can’t usually ask for, or use, the results of predictive tests.

If you have a family history of cancer but you have had a favourable genetic test result, you may want to tell the insurer about it. If you don’t have any other health issues, you could get cover without any special conditions or limits.

To find out more about genetic tests, visit the website of the Association of British Insurers and search for ‘genetic testing’.


Claiming on health insurance

If you have been diagnosed with cancer or you are off work because of it, you may be able to claim against any health insurance policies you already have.

You should claim as soon as possible. There will usually be a time limit (for example, six months). After this time, you may not be able to claim.

Before paying you any money, the insurer will do careful checks to make sure the claim is valid. This is likely to include asking for medical reports from your GP and cancer specialist. You may also be asked to have a medical examination with another doctor.

Paying out on a claim will usually take a few weeks. Some payouts may affect what state benefits you can get.

Check your policy documents for details of how to make a claim. If you used an insurance broker or financial adviser when you took out the policy, they should be able to help with your claim. 

You can also contact our financial guides for help with making a claim. Call them free on 0800 808 00 00.


Mortgage payment protection insurance (MPPI)

If you are diagnosed with cancer and have a mortgage, you may have mortgage payment protection insurance (MPPI). This type of insurance may have been offered when you first arranged your mortgage. These policies might be called ‘short-term income protection’ (STIP).

MPPI pays your monthly mortgage payments (and sometimes a bit extra) if you are unable to work due to an accident, sickness or redundancy. The amount it pays out depends on how much insurance cover you paid for when you took the policy.

With some MPPI policies you have to keep paying the premium even while you are claiming. Make sure you know whether your policy says you need to do this.

Claiming on MPPI

If you want to claim on MPPI you should do it as soon as possible. The payout usually starts one or two months after the claim, but it can take longer. This is called the period of notice.

With some policies, payments are back-dated to the first day you stopped working. This is sometimes called ‘back-to-day-one cover’.

An MPPI payout should cover your whole mortgage payment. It may also provide a small amount of money to help with bills as well.

MPPI provides useful short-term help but usually pays out for a maximum of 12 months. It is important to keep up your mortgage payments after that time to avoid any risk of losing your home.

People who have a low income and get certain benefits may also be able to get support with paying their mortgage interest. Visit GOV.UK (England, Scotland and Wales) for more details, or NI Direct (Northern Ireland).

If you are struggling with money problems, you may find our information about planning and managing your finances helpful.


Critical illness cover

Critical illness cover pays out an amount of money (a lump sum) that is tax-free if you are diagnosed with a life-threatening health condition such as a heart attack, a stroke, kidney failure and some types of cancer. It also pays out if you become totally and permanently disabled.

You may have bought critical illness cover on its own or it might be combined with life insurance. When it is combined with life insurance, this is sometimes called life and critical illness cover. Sometimes your employer will provide this cover as a benefit. You should check with your HR department to see whether your employer offers this.

Claiming on critical illness cover

Not every cancer diagnosis is considered to be life-threatening. This means not everyone diagnosed with cancer will be able to get a payout under critical illness cover. Check the wording of your policy to see which cancers are covered. If the wording is not clear, contact your insurer.

The payout can be used for any purpose. For example, to pay off your mortgage, to pay bills during a period off work, cover private treatment costs in the UK or abroad, or pay for a holiday.

Even if your cancer does not cause a payout on your critical illness cover by itself, you may still be able to claim. If you are left disabled and won’t be able to go back to work, you may be able to claim. This would be under a ‘total and permanent disability’ clause. Depending on the policy, this might apply if you cannot do:

  • the same work as before, or similar work
  • a specified number of work-related tasks
  • any work.

Our critical illness cover will be paid in full. I know now my family will have a house that is paid for and enough in the bank to live on.

Simon


Income protection insurance

This pays out a monthly income if you cannot work because of illness or disability.

If you have taken out your own income protection insurance, you will have chosen the level of income it pays out. You will also have chosen a waiting period. This is a delay between the start of the illness and the start of the insurance payout. It may be from one month to two years. You do not have to pay tax on a payout from a policy you have arranged yourself.

You might have income protection insurance available through your employer. Check this with your HR department.

Claiming on income protection insurance

Income protection insurance usually carries on paying out until you either go back to work or reach retirement age.

Some policies only pay out for a maximum term, such as five years, or less for short-term policies. Some policies pay out less if you are able to return to work part-time.

Remember to check whether you need to keep paying the premium while you claim.

If you have income protection insurance through your employer, they will deal with the claim. The payout is paid to you like ordinary pay, with tax and National Insurance taken off.

While you are receiving payments, your claim will be regularly reviewed by the insurer. They will look for new medical evidence that may show a change in your situation. The payments may stop if you are considered able to return to work.

You should let the insurer know if you change your occupation or move home after buying income protection insurance. If you don’t, there is a chance your claim will be refused.

If you claim benefits, they might be affected by a payout from income protection insurance. Or your payout may be affected by the fact you get benefits. Speak to one of our financial guides for more information.


Payment protection insurance (PPI)

If you are diagnosed with cancer and have a personal loan or credit card, you may have payment protection insurance (PPI). This should cover your loan or card repayments if you are signed off sick from work.

Claiming on PPI

If you want to claim on your payment protection insurance you should make the claim as soon as possible.

Usually, the payout only starts after a waiting period of around 30 to 60 days. With some policies, payments are backdated to the start of the period you were off work. PPI usually pays out for a maximum of 12 or 24 months.

In the past, PPI has been sold in situations where it should not have been sold. If your claim is turned down and you feel that it wasn’t made clear to you when you took out the insurance that claims like yours would not be covered, you should consider making a complaint. You may be able to get compensation.

Many people have used a claims management company to complain and seek compensation on their behalf. Be aware that these companies will take a percentage of any compensation you are awarded. For more information about making a complaint, contact our financial guides.


Private medical insurance

If you have private medical insurance (PMI) it may cover the cost of some or all private treatment for cancer. This may be either your own policy or cover through your employer.

PMI is designed to cover acute medical conditions but not chronic medical conditions:

  • An acute condition is one that is likely to respond quickly to treatment, or that you are likely to recover from.
  • A chronic condition continues over a long period, or may sometimes come back.

There can be confusion about when cancer counts as acute or chronic. You should speak to your insurer to discuss your situation.

You must get the insurer’s approval for any course of treatment before it goes ahead. If you don’t approve, they may refuse to pay if you make a claim.

Macmillan Cancer Support worked with the Association of British Insurers (ABI) to make sure PMI insurers have a separate section that explains the cover for cancer using agreed examples. You will need to check the wording of the policy and it may be helpful to discuss it with the insurer.

Claiming on private medical insurance

There may be arrangements for your insurer to pay your medical bills directly. Or you may need to pay your medical bills first, then collect receipts for the bills and send them to your insurer to claim a refund.

For medical insurance provided through your employer, contact your HR department for guidance on making a claim.

Back to Head & neck cancers

Diagnosing

causes and risk factors of head and neck cancers

Organising

the practical, work and financial side

Treating

head and neck cancers and what to expect

Coping

with and after treatment for head and neck cancers

Resources

and publications to order, download and print